Symptoms of Lyme Disease

Lyme disease symptoms will differ between people depending on the stage of the infection. In some, symptoms may not be present.

Early Infection

These symptoms typically occur within 3-32 days of a tick bite.

Rash

A hallmark symptom of Lyme disease is a red rash, known as erythema migrans (EM). The rash starts as a small red spot at the site of the tick bite and expands over a period of days or weeks, forming a circular- or oval-shaped rash. The rash often resembles a bull’s eye: a red ring surrounding a clear or bluish area with a red center. The size of the rash can range from dime-sized to the entire width of a person’s back. More than one ring may develop. Typically, the rash goes away within 4 weeks.

Although Lyme disease is often associated with this rash, many people do not have the rash right away or at all. Or they may have a red rash, without the bull's eye pattern. If you have other symptoms that you think might be due to Lyme disease, see your doctor; do not wait for a rash to appear.

Flu-like Symptoms

Muscle and joint aches, headache, fever (a temperature of 100-103°F or 37.7-39.4°C), stiff neck, swollen glands, and fatigue may occur with or without the rash. These symptoms usually last about 5-21 days.

Early Widespread Infection

Multiple EM lesions—The rash may appear in several places on the body.

Arthritis—Sometimes joint pain is the first symptom that is noticed. Other joint problems include stiffness and swelling, particularly in the large joints, such as the knee, elbow, and shoulder.

Nervous system problems—The bacteria can affect the brain, spinal cord, and other nerves of the body. Symptoms of this include:

Weakness and drooping of the face and eyelid on one side or both on both sides of the face—Bell’s palsy

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

A history of Lyme disease, symptoms, diagnosis, treatment, and prevention.
National Institute of Allergy and Infectious Diseases website. Available at:
http://www.niaid.nih.gov/topics/lymeDisease/Pages/history.aspx.
Updated March 29, 2011. Accessed September 26, 2012.

Signs and symptoms of untreated lyme disease. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/lyme/signs%5Fsymptoms/index.html. Updated July 26, 2012. Accessed September 26, 2012.